Daytime Somnolence and Sleep Apnea Are Associated With Dizziness in the Elderly

Objective Dizziness is a debilitating multifactorial disorder commonly affecting the elderly. Daytime somnolence and sleep apnea have been linked to dizziness, but previous studies were limited by small sample sizes. The purpose of this study was to examine the relationship between dizziness and daytime somnolence and sleep-disordered breathing, in a nationally representative sample of elderly adults, while adjusting for possible confounders and mediators. Study Design Data from the National Health and Nutrition Examination Study (NHANES; 2017–2020 prepandemic data) were analyzed in a cross-sectional manner using survey methods. Setting Community-based setting in the United States. Participants A total of 1,490 nationally representative participants aged ≥70 years. Main Outcomes Multivariable logistic regression was used to examine the relationship between dizziness and daytime somnolence, snoring, and apnea, while adjusting for covariates (gender, age, body mass index, and various medical conditions that may confound this relationship). Results Frequent daytime somnolence five or more times monthly (odds ratio, 2.13; 95% confidence interval, 1.49–3.06) and presence of apnea (odds ratio, 1.65; 95% confidence interval, 1.20–2.27) were found to be associated with greater odds of dizziness when adjusting for medical comorbidities. A significant association was not found between snoring and dizziness. Conclusions and Relevance In the elderly, daytime somnolence and apnea were independently associated with increased odds of dizziness, even after adjusting for medical comorbidities. Daytime somnolence and sleep apnea should be added to the differential diagnosis in this patient population. Optimizing sleep may help reduce symptoms of dizziness in this population, but prospective studies would be required to confirm these findings. Level of evidence: 4